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Evaluation of Nebivolol Therapy in Patients with Heart Failure on Exercise Tissue Doppler Echocardiographic Parameters

Year 2022, Volume: 44 Issue: 1, 31 - 37, 30.03.2022
https://doi.org/10.7197/cmj.1024721

Abstract

Objective: Heart failure is one of the most important disease which threats population’s health. Its prevalance increases both in our country and in the world in years. Nebivolol is a molecule which is proved its efficacy in the treatment of heart failure. The aim of this study was to evaluate the changes in echocardiographic parameters such as tissue doppler imaging and myocardial performance index (MPI) after 6 months of nebivolol treatment in patients with heart failure.
Method: 20 patients with heart failure were enrolled to the study The average age was 59.8 ± 8.4 years (15 men, 5 women). During rest and exercise (cycle ergometer) we recorded conventional and tissue doppler parameters. In the first examination we recorded basal measurements. Then nebivolol treatment was administered. After 6 months nebivolol treatment we measured again same echocardiographic parameters.
Results: The average Ejection fraction (EF) of patients with heart failure in this study was %38.85 ± 6.45 in the first examination. The average EF was increased to %40.95 ± 5.47 in the end of the study (p<0.05). After 6 months nebivolol treatment both during rest and exercise we found significant improvements in the tissue doppler parameters and MPI.
Conclusions: Nebivolol is associated with significant improvements in EF in the patients with heart failure. In addition, both during rest and exercise, it’s associated with improvements in tissue doppler parameters which can show beneficial effect on the prognosis of this group of patients.

References

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  • 2. The Merit HF study group. Effect of metoprolol CR/XL in chronic heart failure: metoprolol CR/XL randomized intervention trail in congestive heart failure. Lancet 1999;353:9–13.
  • 3. Shibata MC, Flather MD, Bohm M, Borbola J, Cohen-Solal A, Dumitrascu D,et al. Study of the effect of nebivolol intervention on outcomes and rehospitalisation in seniors with heart failure. Rationale and design. Inter J Cardiol 2002;86:77–85.
  • 4. Flather MD, Shibata MC, Coats AJS, Van Veldhuisen DJ, Parkomenko A, Borbola J, et al. Randomized trial to determine the effect of nebivolol on mortality and cardiovascular admission in elderly patients with heart failure. Eur Heart J 2005;26:215–25.
  • 5. Bristow MR, Gilbert EM, Abraham WT, Adams KF, Fowler MB, Hershberger RE, et al. Carvedilol produces dose-related improvements in left ventricular function and survival in subjects with chronic heart failure. Circulation 1996;94:2807–16.
  • 6. Doughty RN, Whalley GA, Gamble G, MacMahon S, Sharpe N. Left ventricular remodelling with carvedilol in patients with congestive heart failure due to ischemic heart disease. J Am Coll Cardiol 1997;29:1060–6.
  • 7. Lechat P, Escolano S, Golmard JL, Lardoux H, Witchitz S, Henneman JA, et al. Prognostic value of bisoprolol-induced hemodynamic effects in heart failure during the cardiac insufficiency bisoprolol study. Circulation 1997;96:2197–205.
  • 8. Groenning BA, Nilson JC, Sondengaard L, Fritz-Hansen T, Larsson HBW, Hildebrandt PR. Antiremodeling effects on the left ventricle during beta-blockade with metoprolol in the treatment of chronic heart failure. J Am Coll Cardiol 2000;36:2072–80.
  • 9. Tzemos N, Lim PO, MacDonald TM. Nebivolol reverses endothelial dysfunction in essential hypertension: a randomised, double blind, cross-over study. Circulation 2001;104:511–14.
  • 10. Hamdan A, Shapira Y, Bengai T, Mansur M, Vaturi M, sulkes J, et al. Tissue doppler imaging in patients with advanced heart failure: relation to functional class and prognosis. J Heart Lung Transplant 2006;25:214-8.
  • 11. Wang M, Yip G, Wang AY, zhang Y, Ho PY, Tse MK, et al. Peak early distolic mitral annulus velocity by tissue doppler imaging adds independent and incremental prognostic value. J Am Coll Cardiol 2003;41:820-6.
  • 12. Wang M, Yip G, Yu CM, Zhang Q, Zhang Y, Tse D, et al. Independent and incremental prognostic value of early mitral annulus velocity in patients with impaired left ventricular systolic function. J Am Coll Cardiol 2005;45:272-7.
  • 13. Hillis GS, Ujino K, Mulvagh SL, Hagen ME, Oh JK. Echocardiographic indices of increased left ventricular filling pressure and dilation after acute myocardial infarction. J Am Soc Echocardiogr 2006;19;450-6.
  • 14. Hillis GS, Moller JE, Pelikka PA, Gersh BJ, Wright RS, Ommen SR, et al. Noninvasive estimation of left ventricular filling pressure by E/e’ is a powerful predictor of survival after acute myocardial infarction. J Am Coll Cardiol 2004;43:360-7.
  • 15. Rihal CS, Nishimura RA, Hatle LK, Bailey KR, Tajik AJ. Systolic and diastolic dysfunction in patients with clinical diagnosis of dilated cardiomyopathy. Relation to symptoms and prognosis. Circulation 1994;90:2772-9.
  • 16. Pinamonti B, Di Lenarda A, Sinagra G, Camerini F. Restrictive left ventricular filling pattern in dilated cardiomyopathy assessed by Doppler echocardiography: clinical, echocardiographic and hemodynamic correlations and prognostic implications. Heart Muscle Disease Study Group. J Am Coll Cardiol 1993;22:808-15.
  • 17. Cheitlin MD, Alpert JS, Armstrong WF, Aurigemma GP, Beller GA, Bierman FZ, et al. ACC/AHA guidelines for the clinical application of echocardiography. A report of the American College of Cardiology/American Heart Association task force on practice guidelines. Developed in collaboration with the American Society of Echocardiography. Circulation 1997;95:1686-744.
  • 18. Mandinov L, Eberli FR, Seiler C, Hess OM. Diastolic heart failure. Cardiovasc Res 2000;45:813-25.
  • 19. Acil T, Wichter T, Stypmann J, Janssen F, Paul M, Grude M, et al. Prognostic value of tissue Doppler imaging in patients with chronic congestive heart failure. Int J Cardiol 2005;103:175-81.
  • 20. Gulati VK, Katz WE, Follansbee WP, Gorcsan J 3rd. Mitral annular descent velocity by tissue Doppler echocardiography as an index of global left ventricular function. Am J Cardiol 1996;77:979-84.
  • 21. Yamamoto T, Oki T, Yamada H, Tanaka H, Ishimoto T, Wakatsuki T, et al. Prognostic value of the atrial systolic mitral annular motion velocity in patients with left ventricular systolic dysfunction. J Am Soc Echocardiogr 2003;16:333-9.
  • 22. Nikitin NP, Witte KK, Thackray SD, et al. Longitudinal ventricular function: normal values of atrioventricular annular and myocardial velocities measured with quantitative two dimensional color Doppler tissue imaging. J Am SocEchocardiogr 2003;16:906–21.
  • 23. Düzenli MA, Özdemir K, Aygül N, Zengin K, Gök H. Kalp yetersizliği olan hastalarda fonksiyonel kapasitenin değerlendirilmesinde doku doppler ekokardiografinin yeri. Arch Turk Soc Cardiol 2008;36:143-9.
  • 24. Tei C, Nishimura RA, Seward JB, Tajik AJ. Noninvasive Doppler-derived myocardial performance index: correlation with simultaneous measurements of cardiac catheterization measurements. J Am Soc Echocardiogr 1997;10:169–78.
  • 25. Tei C, Ling LH, Hodge DO, Bailey KR, Oh JK, Rodeheffer RJ, Tajik AJ, Seward JB. New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function—a study in normals and dilated cardiomyopathy. J Cardiol 1995;26:357–66.
  • 26. Kapusta L, Groot-Loonen J, Thijssen JM, DeGraaf R, Daniels O. Regional cardiac wall motion abnormalities during and shortly after anthracyclines therapy. Med Pediatr Oncol 2003;5:426–35.
  • 27. Klewer SE, Goldberg SJ, Donnerstein RL, Berg RA, Hutter JJ. Dobutamine stress echocardiography: a sensitive indicator of diminished myocardial function in asymptomatic doxorubicin treated long-term survivors of childhood cancer. J Am Coll Cardiol 1992;2:394–401.
  • 28. Dujardin KS, Tei C, Yeo TC, Hodge DO, Rossi A, Seward JB. Prognostic value of a Doppler index combining systolic and diastolic performance in idiopathic-dilated cardiomyopathy. Am J Cardiol 1998;82:1071–6.
  • 29. Bruch C, Schmermund A, Marin D, Katz M, Bartel T, Schaar J, Erbel R. Tei-index in patients with mild-to-moderate congestive heart failure. Eur Heart J 2000;21:1888–95.
  • 30. Downes TR, Nomeir AM, Stewart K, Mumma M, Kerensky R, Little WC. Effect of alternation in loading conditions on both normal and abnormal patterns of left ventricular filling in healthy individuals. Am J Cardiol 1990;65:377–82.
  • 31. Hurrell DG, Nishimura RA, Ilstrup DM, Appleton CP.Utility of preload alternation in assessment of left ventricularfi lling pressure by Doppler echocardiography: a simultaneouscatheterization and Doppler echocardiographic study. J Am Coll Cardiol 1997;30:459–67.
  • 32. Sasao H, Noda R, Hasegawa T, Endo A, Oimatsu H, Takada T. Prognostic value of the Tei index combining systolic and diastolic myocardial performance in patients with acute myocardial infarction treated by successful primary angioplasty. Heart Vessels 2004;19:68–74.
  • 33. Arnlov J, Lind L, Andren B, Riserus U, Berglund L, Lithell H. A Doppler-derived index of combined left ventricular systolic and diastolic function is an independent predictor of cardiovascular mortality in elderly men. Am Heart J 2005;149:902–7.
  • 34. Gaulito L, Ignone G, DeMaria AN. Contraction and relaxation velocities of the normal left ventricle using pulsed-wave tissue Doppler echocardiography. Am J Cardiol 1998;81:609–14.
Year 2022, Volume: 44 Issue: 1, 31 - 37, 30.03.2022
https://doi.org/10.7197/cmj.1024721

Abstract

References

  • 1. Yuichi N, Maureen GM, Stephanie JO, Takahiro S. Enhanced ventricular untwisting during exercise: a mechanistic manifestation of elastic recoil described by Doppler tissue ımaging. Circulation, 2006;113:2524-33.
  • 2. The Merit HF study group. Effect of metoprolol CR/XL in chronic heart failure: metoprolol CR/XL randomized intervention trail in congestive heart failure. Lancet 1999;353:9–13.
  • 3. Shibata MC, Flather MD, Bohm M, Borbola J, Cohen-Solal A, Dumitrascu D,et al. Study of the effect of nebivolol intervention on outcomes and rehospitalisation in seniors with heart failure. Rationale and design. Inter J Cardiol 2002;86:77–85.
  • 4. Flather MD, Shibata MC, Coats AJS, Van Veldhuisen DJ, Parkomenko A, Borbola J, et al. Randomized trial to determine the effect of nebivolol on mortality and cardiovascular admission in elderly patients with heart failure. Eur Heart J 2005;26:215–25.
  • 5. Bristow MR, Gilbert EM, Abraham WT, Adams KF, Fowler MB, Hershberger RE, et al. Carvedilol produces dose-related improvements in left ventricular function and survival in subjects with chronic heart failure. Circulation 1996;94:2807–16.
  • 6. Doughty RN, Whalley GA, Gamble G, MacMahon S, Sharpe N. Left ventricular remodelling with carvedilol in patients with congestive heart failure due to ischemic heart disease. J Am Coll Cardiol 1997;29:1060–6.
  • 7. Lechat P, Escolano S, Golmard JL, Lardoux H, Witchitz S, Henneman JA, et al. Prognostic value of bisoprolol-induced hemodynamic effects in heart failure during the cardiac insufficiency bisoprolol study. Circulation 1997;96:2197–205.
  • 8. Groenning BA, Nilson JC, Sondengaard L, Fritz-Hansen T, Larsson HBW, Hildebrandt PR. Antiremodeling effects on the left ventricle during beta-blockade with metoprolol in the treatment of chronic heart failure. J Am Coll Cardiol 2000;36:2072–80.
  • 9. Tzemos N, Lim PO, MacDonald TM. Nebivolol reverses endothelial dysfunction in essential hypertension: a randomised, double blind, cross-over study. Circulation 2001;104:511–14.
  • 10. Hamdan A, Shapira Y, Bengai T, Mansur M, Vaturi M, sulkes J, et al. Tissue doppler imaging in patients with advanced heart failure: relation to functional class and prognosis. J Heart Lung Transplant 2006;25:214-8.
  • 11. Wang M, Yip G, Wang AY, zhang Y, Ho PY, Tse MK, et al. Peak early distolic mitral annulus velocity by tissue doppler imaging adds independent and incremental prognostic value. J Am Coll Cardiol 2003;41:820-6.
  • 12. Wang M, Yip G, Yu CM, Zhang Q, Zhang Y, Tse D, et al. Independent and incremental prognostic value of early mitral annulus velocity in patients with impaired left ventricular systolic function. J Am Coll Cardiol 2005;45:272-7.
  • 13. Hillis GS, Ujino K, Mulvagh SL, Hagen ME, Oh JK. Echocardiographic indices of increased left ventricular filling pressure and dilation after acute myocardial infarction. J Am Soc Echocardiogr 2006;19;450-6.
  • 14. Hillis GS, Moller JE, Pelikka PA, Gersh BJ, Wright RS, Ommen SR, et al. Noninvasive estimation of left ventricular filling pressure by E/e’ is a powerful predictor of survival after acute myocardial infarction. J Am Coll Cardiol 2004;43:360-7.
  • 15. Rihal CS, Nishimura RA, Hatle LK, Bailey KR, Tajik AJ. Systolic and diastolic dysfunction in patients with clinical diagnosis of dilated cardiomyopathy. Relation to symptoms and prognosis. Circulation 1994;90:2772-9.
  • 16. Pinamonti B, Di Lenarda A, Sinagra G, Camerini F. Restrictive left ventricular filling pattern in dilated cardiomyopathy assessed by Doppler echocardiography: clinical, echocardiographic and hemodynamic correlations and prognostic implications. Heart Muscle Disease Study Group. J Am Coll Cardiol 1993;22:808-15.
  • 17. Cheitlin MD, Alpert JS, Armstrong WF, Aurigemma GP, Beller GA, Bierman FZ, et al. ACC/AHA guidelines for the clinical application of echocardiography. A report of the American College of Cardiology/American Heart Association task force on practice guidelines. Developed in collaboration with the American Society of Echocardiography. Circulation 1997;95:1686-744.
  • 18. Mandinov L, Eberli FR, Seiler C, Hess OM. Diastolic heart failure. Cardiovasc Res 2000;45:813-25.
  • 19. Acil T, Wichter T, Stypmann J, Janssen F, Paul M, Grude M, et al. Prognostic value of tissue Doppler imaging in patients with chronic congestive heart failure. Int J Cardiol 2005;103:175-81.
  • 20. Gulati VK, Katz WE, Follansbee WP, Gorcsan J 3rd. Mitral annular descent velocity by tissue Doppler echocardiography as an index of global left ventricular function. Am J Cardiol 1996;77:979-84.
  • 21. Yamamoto T, Oki T, Yamada H, Tanaka H, Ishimoto T, Wakatsuki T, et al. Prognostic value of the atrial systolic mitral annular motion velocity in patients with left ventricular systolic dysfunction. J Am Soc Echocardiogr 2003;16:333-9.
  • 22. Nikitin NP, Witte KK, Thackray SD, et al. Longitudinal ventricular function: normal values of atrioventricular annular and myocardial velocities measured with quantitative two dimensional color Doppler tissue imaging. J Am SocEchocardiogr 2003;16:906–21.
  • 23. Düzenli MA, Özdemir K, Aygül N, Zengin K, Gök H. Kalp yetersizliği olan hastalarda fonksiyonel kapasitenin değerlendirilmesinde doku doppler ekokardiografinin yeri. Arch Turk Soc Cardiol 2008;36:143-9.
  • 24. Tei C, Nishimura RA, Seward JB, Tajik AJ. Noninvasive Doppler-derived myocardial performance index: correlation with simultaneous measurements of cardiac catheterization measurements. J Am Soc Echocardiogr 1997;10:169–78.
  • 25. Tei C, Ling LH, Hodge DO, Bailey KR, Oh JK, Rodeheffer RJ, Tajik AJ, Seward JB. New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function—a study in normals and dilated cardiomyopathy. J Cardiol 1995;26:357–66.
  • 26. Kapusta L, Groot-Loonen J, Thijssen JM, DeGraaf R, Daniels O. Regional cardiac wall motion abnormalities during and shortly after anthracyclines therapy. Med Pediatr Oncol 2003;5:426–35.
  • 27. Klewer SE, Goldberg SJ, Donnerstein RL, Berg RA, Hutter JJ. Dobutamine stress echocardiography: a sensitive indicator of diminished myocardial function in asymptomatic doxorubicin treated long-term survivors of childhood cancer. J Am Coll Cardiol 1992;2:394–401.
  • 28. Dujardin KS, Tei C, Yeo TC, Hodge DO, Rossi A, Seward JB. Prognostic value of a Doppler index combining systolic and diastolic performance in idiopathic-dilated cardiomyopathy. Am J Cardiol 1998;82:1071–6.
  • 29. Bruch C, Schmermund A, Marin D, Katz M, Bartel T, Schaar J, Erbel R. Tei-index in patients with mild-to-moderate congestive heart failure. Eur Heart J 2000;21:1888–95.
  • 30. Downes TR, Nomeir AM, Stewart K, Mumma M, Kerensky R, Little WC. Effect of alternation in loading conditions on both normal and abnormal patterns of left ventricular filling in healthy individuals. Am J Cardiol 1990;65:377–82.
  • 31. Hurrell DG, Nishimura RA, Ilstrup DM, Appleton CP.Utility of preload alternation in assessment of left ventricularfi lling pressure by Doppler echocardiography: a simultaneouscatheterization and Doppler echocardiographic study. J Am Coll Cardiol 1997;30:459–67.
  • 32. Sasao H, Noda R, Hasegawa T, Endo A, Oimatsu H, Takada T. Prognostic value of the Tei index combining systolic and diastolic myocardial performance in patients with acute myocardial infarction treated by successful primary angioplasty. Heart Vessels 2004;19:68–74.
  • 33. Arnlov J, Lind L, Andren B, Riserus U, Berglund L, Lithell H. A Doppler-derived index of combined left ventricular systolic and diastolic function is an independent predictor of cardiovascular mortality in elderly men. Am Heart J 2005;149:902–7.
  • 34. Gaulito L, Ignone G, DeMaria AN. Contraction and relaxation velocities of the normal left ventricle using pulsed-wave tissue Doppler echocardiography. Am J Cardiol 1998;81:609–14.
There are 34 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Medical Science Research Articles
Authors

Ufuk İyigün 0000-0002-6693-8822

Fatih Yalçın 0000-0002-4273-2766

Publication Date March 30, 2022
Acceptance Date March 20, 2022
Published in Issue Year 2022Volume: 44 Issue: 1

Cite

AMA İyigün U, Yalçın F. Evaluation of Nebivolol Therapy in Patients with Heart Failure on Exercise Tissue Doppler Echocardiographic Parameters. CMJ. March 2022;44(1):31-37. doi:10.7197/cmj.1024721